Colorectal surgery

What we do

We provide a specialist colorectal service at both Chelsea and Westminster Hospital and West Middlesex University Hospital, looking after patients with all problems affecting the large bowel (colon), small bowel (intestines) and the rectum and anus (bottom).

We offer fourteen outpatient clinics a week in which we see new and follow up patients. We have a ‘straight to test’ protocol for suspected colorectal cancer patients. This involves a nurse-led telephone assessment clinic, following which patients attend for their investigations. This innovative approach reduces patient waiting time, and streamlines the patient’s pathway.

Patients with stomas (‘a bag’) are able to see our stoma therapists in their daily outpatient clinics. Our cancer clinical nurse specialists hold daily clinics helping patients being treated or followed up for colorectal cancer. 

Conditions we treat include:

  • Colorectal and anal cancer 
  • Inflammatory bowel disease (ulcerative colitis and Crohn’s disease)
  • Diverticular disease
  • Anal fissures and fistulas, haemorrhoids (piles), abscesses and warts
  • Pelvic floor dysfunction and bowel disorders including incontinence and chronic constipation
  • Complex abdominal wall hernias

All consultant surgeons perform laparoscopic/robotic (keyhole) surgery for most colorectal disorders. All consultant surgeons also perform the full range of general surgical procedures and manage emergency general surgery and colorectal surgery admissions to the hospital.

Who we are

The colorectal team includes:

  • Mr Valerio Celentano
  • Mr Christos Kontovounisios
  • Ms Sarah Mills
  • Ms Laura Muirhead
  • Mr Chris Nicolay
  • Mr Nikhil Pawa
  • Mr Jason Smith
  • Prof Paris Tekkis
  • Ms Bubby Thava
  • Mr Oliver Warren

Colorectal cancer

We have a comprehensive multidisciplinary pathway for diagnosis, treatment and follow-up of colorectal cancer. 

Inflammatory bowel disease (IBD) and ileoanal pouch surgery centre

We are a tertiary referral centre for Crohn’s disease and ileoanal pouch surgery. Our multidisciplinary IBD team has a high volume practice in surgical treatment of primary and recurrent Crohn’s disease, Kono-s anastomosis, fistulating and perianal Crohn’s disease. We are one of the highest volume centres in ileoanal “j-pouch” surgery, performing primary and revisional ileoanal pouch surgery, and pouch excision.

We work closely with paediatric surgeons and gastroenterologists caring for adolescents with IBD and other colorectal conditions, transitioning to the adult services.

The ileoanal J-pouch clinic is a multidisciplinary service offered to patients who have an ileoanal pouch or are considering having surgery. This one-stop clinic involves an endoscopic assessment of the pouch (pouchoscopy) and same-day meeting with our team of colorectal surgeons, gastroenterologists, IBD and stoma/pouch nurses. Dedicated imaging is also arranged on the same day as required. 

Conditions usually evaluated in the J-pouch clinic include pouchitis, pouch dysfunction, pouch-anal and pouch-vaginal fistulae, increased bowel frequency, primary ileoanal pouch and redo pouch surgery, and surgical treatment of ulcerative colitis. Patients and GPs will be able to link directly to the team to answer queries and arrange appointments and follow-up.

The excellent care provided by the IBD and ileoanal pouch surgery centre has been awarded nationally by the British Society of Gastroenterology. Our IBD centre has a florid research and education activity, hosting national courses and leading on NIHR and multicentre studies.

We can receive GP referrals or patients can self-refer by emailing chelwest.j-pouch@nhs.net. A preliminary telephone/virtual appointment is often arranged prior to face-to-face consultation.

The IBD and ileoanal pouch surgery centre is directed by Mr Valerio Celentano (Consultant Colorectal Surgeon) who can be reached on Valerio.celentano@nhs.net.

Complex abdominal wall reconstruction unit

The complex abdominal wall reconstruction and incisional hernia unit specialises in the treatment and care of patients with complex abdominal wall hernias.

The CAWR unit is run with a systematic multidisciplinary approach including specialist surgeons (colorectal, upper GI and plastic surgery) and with expertise from radiology, anaesthetics and bariatric services. This multi-professional approach ensures each patient is afforded expert opinion from medical disciplines that may be beneficial to their care.

Upon referral to the unit each patient is seen individually in clinic. Here they will undergo clinical assessment, be referred for routine blood tests, undergo cross-sectional imaging (CT or MRI) and will undergo medical photography.

All patients are then discussed in the multidisciplinary team (MDT) meeting where individual plans for patients are decided upon to ensure optimal outcomes. This includes preoperative optimisation as well as operative and postoperative planning.  The MDT is now a regional MDT, with colleagues from other units across London and the South East dialling in or attending to discuss their cases, or refer patients.

Established in 2016, the unit is led by Mr Oliver Warren, a specialist in this area who has done over 100 of these complex operations, and has published and presented Chelsea and Westminster Hospital’s results widely.

Features of the unit

  • Specialist imaging and radiology
  • Expertise in complex hernia repair including component separation and transversus abdominus release
  • Parastomal hernia repair, pernineal hernia repair, plastic reconstruction, abdominoplasty
  • Expertise in anaesthetics and pain management
  • Botox injection pre-operatively
  • Integrated links with pre-operative assessment and intensive care

Anal cancer and HPV

Anal cancer is caused by high-risk strains of the Human Papillomavirus (HPV) and is rising in incidence in certain high-risk populations. Like other HPV driven cancers, such as vulval, vaginal and cervical cancer, anal cancer also has its own precancerous precursor called anal squamous intraepithelial lesion. The ANCHOR study published in June 2022 was the first to demonstrate that the treatment of anal high-grade squamous intraepithelial lesions (HSIL) significantly reduces disease progression to invasive anal cancer, by as much as 57%. These findings have influenced how we approach anal precancerous lesions and has highlighted the need for early treatment and close surveillance. 

At Chelsea and Westminster Hospital, the Colorectal Team is a key participant of the Anogenital Dysplasia Multidisciplinary Team, which also includes the HIV and Sexual Health Services, Dermatology and Gynaecology Departments. 

Together we manage patients at high-risk of anal and genital cancer such as women with multizonal anogenital HSIL, immunosuppressed patients and patients living with HIV. We run regular multidisciplinary Anogenital Dysplasia operative lists dedicated to the treatment of Anogenital HSIL and provide services such as high resolution anoscopy (for the diagnosis and surveillance of anal HSIL) and laser ablation of anogenital HSIL (for the treatment of anogenital HSIL). 

Clinical research

Clinical research is a vital part of the unit. We pride ourselves on continued efforts to improve standards in this specialist area of surgery and improve outcomes for our patients.

We have already published on optimisation of patients to improve outcomes and quality of life outcomes in our patients. We have shown that MDT working provides a robust management framework and improves outcomes. Our work has been presented internationally and contributed to guidance from the British Hernia Society (BHS). Mr Warren sits on the BHS Complex Abdominal Wall sub-committee.

Current research is focussing on a number of key outcomes for patients including, importantly, continuing to evaluate quality of life measures and outcomes.

For more information on stoma care, please visit our dedicated page here.

If your treatment part of the ERAS programme for
colorectal surgery, please see the ERAS page

Study days

We hold study days for health professionals from time to time—find out about upcoming sessions.

Contact information

Chelsea and Westminster Hospital

Our outpatient clinics are located on the Lower Ground Floor of the main hospital site. We perform day surgery in the Treatment Centre on the Ground Floor. The main operating theatres are on the 5th Floor, next to the Intensive Care Unit. Endoscopies are performed in the Diagnostic Centre on the 2nd Floor.

Surgical admissions
T: 020 3315 3590
E:  

Endoscopy
T: 020 3315 4141
E:

Outpatients reception
T: 020 3315 3272

Outpatients appointments
T: 020 3315 6666
E:

West Middlesex University Hospital

The Department of Colorectal Surgery is located in the East Wing of the West Middlesex University Hospital. The contact details for WM are as follows:

Surgical admissions
T: 020 8321 6937
E:

Endoscopy
T: 020 8321 5752
E:

Outpatients appointments
T: 020 3315 6666

General booking enquiries
T: 020 8321 5352/5351
E:

Contributors
layla orhan George Vasilopoulos